Key result
Markedly elevated peak procalcitonin (≥5 ng/ml) in pediatric patients after cardiac surgery was significantly associated with longer cardiopulmonary bypass times (244.5 vs 122.9 min) and prolonged ICU stays.
Cohort (n=52)
No
Absolute Event Rate: 244.5% vs 122.9%
p-value: p=<0.001
Markedly elevated procalcitonin in the early postoperative period after pediatric cardiac surgery is associated with prolonged cardiopulmonary bypass time, longer ICU stay, and organ dysfunction, serving as a potential predictor of postoperative severity.
Elevated procalcitonin may flag higher-risk pediatric cardiac surgery cases; hypothesis-generating and should not yet change practice.
BACKGROUND: We encountered markedly elevated procalcitonin (PCT) among pediatric patients during the early postoperative period of open heart surgery. The purpose of this study is to investigate what factors are associated with the PCT elevation. METHODS: Fifty-two pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were enrolled. Plasma PCT, aspartate aminotransferase/alanine aminotransferase (AST/ALT), creatinine, lactate, and C-reactive protein (CRP) were measured on admission to ICU and during the postoperative period. The patients were categorized into high (group H) and low (group L) groups according to their peak PCT levels. Aorta cross-clamp (ACC), CPB time, ICU stay, mechanical ventilation period, peak AST/ALT, creatinine, lactate, and CRP levels were compared. RESULTS: ACC and CPB times, ICU stay period, and mechanical ventilation period were significantly longer in group H compared with group L (118.7 ± 51.6 vs. 49.4 ± 43.5 min, 244.5 ± 65.7 vs. 122.9 ± 63.0 min, 7.9 ± 4.6 vs. 4.0 ± 4.5 days, and 6.3 ± 4.1 vs. 2.9 ± 4.2 days, respectively; p < 0.01). Peak AST and creatinine were significantly higher in group H compared with group L (999.0 ± 1,990.3 vs. 88.3 ± 43.0 U/l and 0.84 ± 0.77 vs. 0.41 ± 0.17 mg/dl, respectively; p < 0.05). CONCLUSIONS: ACC and CPB time-related perioperative stress is associated with elevated PCT; an association between ICU stay and mechanical ventilation period, liver enzymes, and creatinine levels was observed. PCT may be a good predictor of postoperative severity and organ dysfunction.
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Minami et al. (2014) conducted a cohort in Pediatric patients undergoing open heart surgery with cardiopulmonary bypass (n=52). Markedly elevated peak procalcitonin (≥5 ng/ml) vs. Low peak procalcitonin (<5 ng/ml) was evaluated on Cardiopulmonary bypass (CPB) time in minutes (p=<0.001). Markedly elevated peak procalcitonin (≥5 ng/ml) in pediatric patients after cardiac surgery was significantly associated with longer cardiopulmonary bypass times (244.5 vs 122.9 min) and prolonged ICU stays.
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